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“More than meets the Eye”
Christie Russo
"EMDR (Eye Movement
Desensitization and Reprocessing) therapy has emerged as a
procedure to be reckoned with in psychology....Almost a million people
have been treated ....
Also, further research appears to support the remarkable claims made
for EMDR therapy."
- Reported in The Washington Post, July 21, 1995
"Where traditional
therapies may take years, EMDR takes only a few sessions."
- Reported in The Stars and Stripes, February 12, 1995
"New type of
psychotherapy seen as boon to traumatic disorders."
- Reported
in The New York Times, October 26, 1997
What is Eye Movement Desensitization and Reprocessing?
EMDR combines brief periods of exposure with an external distracting stimulus…
EMDR
is a relatively new and contentious clinical treatment that has been
scientifically evaluated predominantly with trauma survivors and persons
stricken with anxiety. The premise of
EMDR is that traumatic, panic, and anxiety experiences are processed
differently by the brain than pleasant or neutral experiences. EMDR maintains that the amygdala (part of
the temporal lobe responsible for moderating emotions) provisionally shuts down
the hippocampus (complex region in the temporal lobe responsible for long-term
memories) resulting in a heightened reaction to the specific event. Theoretically the memory of the disturbing
experience is trapped beyond the domain of usual brain-processing
abilities. EMDR grants the patient
admission to the experience so that he/she can convert it into a tolerable or
neutral memory. The neuro-physiological
concept behind EMDR is that the hippocampus is not entirely shut down by the
emotions evoked from the induced experience.
Therefore, the patient is able to endure the procedure. Distraction by bilateral stimulation
catalyzes rapid eye movements (REM) similar to that produced during sleep. In theory the REM induced in an EMDR
session trigger an accelerated processing system in which the patient is able
to rapidly absolve upsetting experiences creating an adaptive learning
experience. In simpler terms, the
patient learns to draw out what is necessary and useful from the upsetting
incident.
Who discovered the EMDR method and how?
Francine Shapiro Ph.D.
Spring,
1987—Dr. Francine Shapiro made a chance observation. She was walking one day and realized she was having particularly
disturbing thoughts. When they suddenly
disappeared, her inquisitive nature wanted to know why? So she attempted to re-evoke her previous
thoughts back to mind. However, she
noticed that in doing so, they were “not as upsetting or as valid as before.” Prior experience had taught her, “Disturbing
thoughts…tend to play over and over until you consciously do something to stop
or change them.” So she began to pay
very close attention to her environment and behavior. Shapiro soon noticed that when the
distressing thoughts entered her mind, her eyes began to move quickly, back and
forth, in an upward diagonal. Yet
again, the negative thoughts disappeared.
When they were once again retrieved, their intensity appeared even more
diminished. Fascinated by this
happenstance discovery, Shapiro began to test out her newfound strategy on
friends and colleagues. She discovered
similar results and began to modify her strategy to achieve optimal outcomes. Thus, EMDR entered the scientific realm and
was ready to be tested for reliability and effectiveness. http://www.pseudoscience.org/rosen-and-lohr.htm
What, according
to its founder, is the purpose of EMDR?
· to help the patient learn from negative past experiences
· to desensitize current triggers that are inappropriately
distressing
· to incorporate templates for appropriate future actions that
permit the patient to excel individually and within his/her interpersonal
system
How does bilateral
stimulation/distraction facilitate the processing of distressing
experiences? 
Traditionally,
during EMDR sessions, the patient envisions a traumatic or disturbing event
whilst moving their eyes rapidly back and forth in an upward diagonal,
following the movement of an instrument (pencil, finger, light) controlled by
the therapist. Studies have shown with
an overwhelming rate of success that this process alleviates distress, however,
the exact rationale is unknown. http://www.internalchange.com/tools/emdr.html
The first
controlled study
The
initial pilot research was executed by Francine Shapiro in the winter of
1987. The 22 subjects of her study were
victims of rape, molestation, or Vietnam veterans suffering from tormenting
memories. The subjects were randomly
assigned to one of two groups: treatment or control. The subjects receiving the treatment were administered EMDR
whereas the control group received a placebo treatment consisting of a detailed
dialogue in which the subject was asked to describe their traumatic
recollection. Subjects within both
groups were requested to discuss their individual disturbing image along with
whatever negative thoughts/beliefs they correlated with their participation in
such an event (i.e. “I’m dirty,” “I’m worthless…not in control.”). This negative connotation would be referred
to as “the negative cognition.” The
subjects were then asked to rate their anxiety level according to an 11-point
Subjective Units of Disturbance Scale (SUDS).
Zero would reflect a neutral or non-existent anxiety and ten would
reflect the highest possible level of anxiety.
The subjects were also asked to voice a positive thought they would like
to have about themselves. Lastly, the
subjects were asked to determine the validity of their positive thought,
designated by the Validity of Cognition Scale (VOCS).
The
treatment group demonstrated a decreased level of anxiety and a substantial
increase in the validity of positive cognition. The control group, on the other hand, did not demonstrate such
cognitive restructuring. These subjects
experienced an increase in anxiety as well as a decreased self-efficacy. Shapiro’s study was the first of many to
come to suggest EMDR has significant external validity.
Peer controlled
Studies of EMDR
· “Marcus, Marquis, and Sakai (1997)
evaluated sixty-seven individuals diagnosed with post-traumatic stress disorder
(PTSD) in a controlled study funded by Kaiser Permanente Hospital.” The results of this study indicate that EMDR
may be a superior form of treatment for PTSD than those commonly
practiced. After merely three
fifty-minute sessions, 50% of EMDR participants no longer qualified as
diagnoses of PTSD compared to 20% of recipients of standard hospital care.
· Soloman & Kaufman (1994) determined that when 60 railroad
personnel suffering from traumatic incidents were debriefed by a peer counselor
in conjunction with 20 minutes of EMDR (as opposed to no EMDR), they produced
significantly better scores on the Impact of Event Scales.
http://www.emdr.com/studies.htm
· “Of 445 respondents to a survey of trained clinicians who had treated over 10,000 clients, 76% reported greater positive effects with EMDR than with other methods they had used. Only 4% found fewer positive effects with EMDR.” http://www.ejch.com/emdr.htm
Efficacy of EMDR
EMDR
has been acknowledged as an “empirically validated treatment of trauma” and
recognized by the International Society for Traumatic Stress Studies as “an
effective treatment for PTSD.” In 1998,
the American Psychological Association Division 12 Task Force placed EMDR on a
list of “probable efficacious treatments.” (Chambless, 1998) This is most likely due to the extensive and
highly reliable studies involving EMDR treatment in comparison to standardized
treatments.
Since
its original efficacy study (Shapiro, 1989) positive therapeutic results have
been reported in a diverse group of populations: http://www.emdr.com/eff.htm
Ž Combat veterans who were previously resistant to treatment no
longer show symptoms (Blore, 1997)
Ž Persons with phobias and panic disorders no longer display
the behaviour (de Jongh & ten Broeke, 1998)
Ž Disturbance of violent assault victims significantly reduced
(McNally & Soloman, 1999)
Ž Victims of sexual dysfunction gain ability to maintain a
healthy, sexual relationship (Wernik, 1993)
Ž Children traumatized by natural disaster or assault no longer
possess symptoms of the trauma
Ž People affected by dissociative disorders progress at a
faster rate than those receiving standard treatment (Young, 1994)
Who
administers EMDR?
Administration
of EMDR is limited to mental health professionals who have a masters degree or
higher in the mental health field and are licensed or certified through a state
or national board which authorizes independent practice. http://www.emdr.com
Are
there any side effects to EMDR?
Although negative side effects are not
common, they are entirely possible.
This includes re-experiencing the negative event for several hours or
days after treatment and temporarily increased anxiety. There have been no long-term negative side
effects reported in any data or research.
-----------------References-----------------
Corsini,
R. (2001) Handbook of innovative psychotherapies 133
Phillips, M. (2000) Finding the energy to heal:hoe EMDR,
Hypnosis, TFT, Imagery, and Body-Focused Therapy Can Help Restore Mindbody
Health 240-248
Shapiro,
F. (2001) Eye movement desensitization and
reprocessing : basic principles, protocols, and procedures 1-6, 315-360
